| NPI | 1669488391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 2002-0276) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: WA 48555) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-01-22 |